...or Why I'm Not a Singing CRA.

During those confusing and wondrous years, when a young man ponders his career choices, my dream was to become a singer-songwriter. Blowing my hard-earned profits from an after school job on a multi-track recorder, I spent precious study time mixing down vocal, guitar and synthesizer tracks composing what would surely become the next big platinum album.

My “big break” came when a friend hired me to perform at his birthday party. Then again, maybe "fracture" would be a better term. You see, to be brutally honest — I bombed! It wasn’t that I didn’t have talent (ok, maybe it was,) or that my voice resembled John Denver covering old Yoko Ono favorites.

No, despite my technical expertise in audio technology (a shower stall creates excellent reverberation) and extensive preparation (actually, like with a biology exam … I crammed the night before), my debut performance was a disaster for a completely different reason. My college chum wanted upbeat party music; I gave him punkish blues — Janice Joplin meets the B-52’s.

Art Lessons

Beyond solidifying my commitment to a career more in line with my propensities, I learned valuable lessons that day. As I’ve progressed in that career from pharmacist to Clinical Research Associate (CRA) to entrepreneur and beyond, I’ve found many situations where those same lessons apply. If you are an aspiring songwriter, or particularly a Consultant CRA or just someone who wants to spare themselves from total embarrassment in front of their college friends, then maybe you too will find these lessons of value.

Lesson #1: Give the People What They Want

As a nerdy pharmacy student, I sang about what I considered important (hits like “Count, Pour, Lick, & Stick” and “The Benzodiazepine Blues”), not what my client wanted (songs about girls, fast cars, more girls). I found out the hard way that it’s the client that defines the scope of the assignment.

How does this apply to the consultant? Like my college buddy, the manager who hires a consultant CRA may have expectations substantially different from those of the contractor. An effective clinical research consultant will first elicit those expectations and then select the appropriate songs from his repertoire. As a result of their exposure to a number of different clients, experienced consultants often gain valuable knowledge of the best (also, unfortunately, the not-so-good) methods used in the industry.

But, sometimes, all a hiring manager may want from a “consultant” is a trained worker who will follow the SOPs and one who is a team player. In this case, it would not be a good idea to behave as if you were hired to teach the sponsor how to conduct the study. Perhaps I exaggerate a bit, but it’s really quite common to see a consultant CRA sing off-key. Good consulting technique: like The Kinks’ lyric, “Give the People What They Want.” Bad consulting technique: leave the client singing like The Rolling Stones, “I Can’t Get No Satisfaction.”

Lesson #2: Monet Was a Realist

Think of Renoir or Mozart and common artist stereotypes likely come to mind. Now, think of your friendly neighborhood pharmacist. I bet you get a different picture. [Nonetheless, we pharmacists have our individual styles and creative talents, like how many pills we count per spatula stroke or how we artistically compose that little prescription label.] As humans, we tend to develop preconceived notions that influence how we evaluate the actions and capabilities of others. If you look like a future-pharmacist your friends may have a hard time seeing you as a musician. If you’re a consultant, you must adopt the mannerisms, appearance, and attitude of a professional, if you want to be perceived as one.

Our company uses the concept of Christopher Columbus as an emissary of Queen Isabella to convey to our clients the importance we place on professionalism in our role as their representative. It is a powerful image that also serves as a mission statement for our monitors: to act in a manner that reflects positively on the client. It means that we should be well prepared and should arrive on time for our monitoring visits. It requires that we thoroughly understand the protocol and be well versed in the clinical and therapeutic aspects of the treated condition. It demands that we treat everyone with respect and act in a mature and professional manner.

On the flip side, there’s a corollary to the story of Columbus. On a 1507 map, a cartographer wrote across the southern continent of the New World the word “America” after the explorer Amerigo Vespucci. The name stuck, reflecting the power of the printed word. This, too, is an important lesson for consultant and employee clinical research study monitors alike. The written documents we produce, our monitoring reports and correspondence, will long outlast our actions and will serve as the most visible and lasting demonstration of our performance.

No matter how impressive your credentials or how well you may function as a Clinical Research Associate, if you can’t accurately complete an expense report or compose a “playable“ trip report, your client will never perceive you as an exceptional CRA! It may sound extreme, but to your client, you are what you write!

Write full sentences, not abbreviations, that could be misunderstood years later by someone not involved in the project (say, an FDA reviewer perhaps!)

Lesson #3: Success is the Melody, Attitude the Key

Many pursue consulting as a way to have more control and greater income. I strongly agree that the ability to choose one’s projects is a wonderful thing. On the other hand, even Michelangelo had to do a little painting to support his sculpture habit. Starting a dialog with a potential client by saying “I won’t go to sites in North Dakota…” or “I won’t consider a job for less than…” certainly is not the way to establish a lasting consulting practice. You might also miss a chance to learn about chapel painting!

Income — or more appropriate in the case of an independent consultant — profit, is only a way to measure our resourcefulness at a point in time, mile markers on the long road we call a career. Why and how we achieve this result is what matters. And true “control” is simply a function of perspective. It’s easy to think of the company president as having more control than his subordinates. That is, if you've never had to worry about making a payroll.

I encourage you to ba Clinical Research Associate because you love being involved in developing life-improving medical products and are proud of the work you do. If you have the right attitude and concentrate on building lasting professional relationships, the money will eventually follow. Attitude, like a key in music, is what turns a collection of sharps and flats into a melody.

What about that site in North Dakota? Admittedly, this ol’ Texan is rather intimidated by blizzards and floods that wipe out entire towns. [How do they keep from losing their longhorns in those huge snowbanks?] But, when the client said they needed someone to take this “problem” site, I agreed without complaint (well, at least not aloud). Where previous monitors saw obstacles, I saw an opportunity to make a distinct impact on the success of the study. In my way of thinking, the data from this one site might provide the key information that determines whether the drug is safe and effective.

To my delight, what I found was some of the nicest and most sincere folks in America. It soon became one of my best sites. In fact, it did indeed become one of the top enrolling sites, a critical factor in the success of the study. What's a little frostbite compared to bringing an important new drug to millions of suffering patients!

Finishing Touches

Consulting is an art, something that must be learned over time, not simply by reading books or attending courses. Consulting is more visceral than scientific, as much a weaving of relationships as an application of knowledge. Effective communication skills are the paints and brushes you must use to properly apply your talents. Professionalism is the canvas that displays your work to your audience. Style and attitude determine the critical acceptance you creations will receive.

Starving artists and aspiring consultants need to learn these lessons early in their careers. Even more than college pals, clients can be harsh critics.

This article was originally published in Applied Clinical Trials magazine, July 1998.